How Strong are Different Painkillers: Equianalgesia Introduction

hey guys so good to see you all again this video is going to be an introduction to this concept known as equa analgesia what this means is equal painkilling now a lot of people think that uh painkillers you know whether it's aspirin or fentanyl they think that these painkillers they might be a little bit different but how different are they this video is going to kind of introduce you to the system or the chart by which providers keep them all separate and really try and give you an appreciation of how very strong some of the different drugs that we have so I chose um some examples here these are ones that you've probably heard of and I I guess my goal here is to make you aware of just how strong some of our painkillers are um and how this stuff is not to be messed around with also I kind of want to talk to you about the gold stainer which is a good introduction or good segue here we kind of uh compare the efficacy or um how well a painkiller works by how it compares to oral morphine so that's taking like um 10 mg of oral morphine by mouth or hydrocodone now those are kind of our two like gold standards so really when we're talking about the strength of a pain killer we want to know hey man is it stronger than oral morphine and that's really what we're talking about so I have these listed up here I'm just going to quickly go through them again these are probably ones you've heard of and I'll try and you know yell out any trade names if uh if it comes up um acetyl salicylic acid is actually aspirin and this is going to be the weakest one I'm going to talk about this is 1 360th as strong as hydrocodone so people you know they come into the hospital and they ask for hydrocodone or that sort of thing and they say well hey I mean I've been taking aspirin and it hasn't really even been touching this pain maybe some hydrocodone that is a big step it's a big step from aspirin to oral morphing it's one 1 360th as powerful so we usually taper this down compared to aspirin so if you're taking like you know another nid might be like ibuprofen you might be taking 400 migam of ibuprofen and then they only give you 10 milligrams of morphine or you know that that would even be huge but they're going to the doses will be different to try and compensate for this huge difference in potency the next one on our list is going to be coding which is an anti-us or knocks out your coughing so a lot of people have it in cough syrup form this is one1 as strong as Hydro or oral morphine next one's going to be tramol this is a very very very popular painkiller right now um supposed to be less addictive and also have some sedative properties so they've been handed out tramol like candy lately that's also one10 just like coating the next one is M mine which isn't used as much anymore but it used to be used quite a bit still used by some people and it's commonly called Demerol you might have heard of that that's 13 as potent or as strong as hydrocodone oral morphine this I'm just going write one over one because obviously they're they're you know that's the gold standard that's the the potency we're going for next on this list is going to be oxycodone oxycotton perco set those sort of things um that's going to be 1.5 times as strong as hydrocod or or morphine so if someone said well I took a hydro last night can I have an oxy to to day well they're actually bumping up the scale those aren't synonymous with each other uh before I move too far ahead I wanted to mention real quick you might have heard of hydrocodone in its mixture form with acetam minin or Tylenol um as L tab or no Norco that sort of thing that's how it's commonly prescribed to try and get that extra painkilling kick from aaminin um IV morphine is actually three times as potent as oral morphine now that's because we're injecting it has a high bio availability which uh without going too much into the farm what we're talking about here is if we pump it straight into your bloodstream it's going to hit you a lot perer without being broken down or metabolized versus oral morphine has to you know be absorbed from your gastrointestinal tract that sort of thing next one up on the list here is Hydromorphone Hydromorphone you might have heard of as diloted uh and that's five times as potent as the gold standard here this is commonly used for posttop an Alesia so like uh someone that just had a colomy or some major surgery we might give them some deloted in the uh pacu the post anesthesia car you know that sort of thing next on the list is fentanyl you almost everyone's heard of that that's 500 to a or excuse me 50 to 100 times as potent as Hydro or morphine and the last one I put on here just kind of uh for trivia is etorphine also known as m99 um and this you might recognize is the drug that Dexter in the uh TV show called Dexter used to knock out his victims it hits you so fast it's so rapid acting and it's so strong that it just knocks you unconscious that's why Dexter uses it to knock out the people he's after we don't really use it in human medicine but you know veterinarians people that are knocking out grizzly bears that sort of thing might have it in their Arsenal uh this right here is a quick chart the most common painkillers you'll encounter and what the relative potencies are so just to kind of give you an idea of um how we account for these differences in potencies is like if I gave you 10 mg of oral morphine and you want to know well how much fentanyl would you give me to um get that same effect it would take 10 Mig of these things whereas it would only take 0.1 or2 uh milligrams of fentanyl so you can just kind of divide out you know the potencies and find that out but I'm just trying to really hit this point home whereas if you're taking Tramadol um you would need 10 times as much tramol to get the same effect so it'd have to give you 100 Mig of Tramadol to get the same effect as 10 Mig of hydrocod and that sort of thing so don't make the mistake of saying hey I was on whatever 400 mg of ibuprofen can't you just give me 400 mg of o o codone it doesn't work like that uh different painkillers hit you at different strengths and that's introduction to equo gesia uh let us know if you have any questions thank you

Channel: Med School Made Easy

Views: 449,491

Keywords: Analgesic (Drug), Equianalgesic, drug, pain, painkiller, analgesia, different, strong, strength, potency, potent, how, are, they, med, school, made, easy, msme, comlex, usmle, board, review, pharm, pharmacology, hydrocodone, aspirin, equianalgesia, ibuprofen, oxycodon, what, is, which, prescribe, prescription

Id: 3BnZKiJqzew

Length: 6min 42sec (402 seconds)

Published: Mon Apr 20 2015